Addictions: local healthcare services are failing to identify those in need of treatment
There is a shortfall of 1,976 professionals in the Substance Abuse Services (SerD). Only 164 out of 781 community centres with active services offer dedicated support. A new model for early intervention has been proposed.
People with drug and alcohol addiction problems who do not access services represent one of the main gaps in the local healthcare system. Yet identifying them before problematic use escalates into a more serious condition could make all the difference, both in terms of health and in terms of social and economic costs. Today, however, the public health system is struggling to respond: there is a shortfall of 1,976 professionals in Addiction Services (SerD) compared with the benchmark standards, and only 21 per cent of community centres that have set up at least one service offer dedicated support for addiction.
This is the picture painted by the new report from the Observatory on the Socio-economic Impact of Addictions (Oised), promoted by Crea Sanità and Ce.R.Co, which highlights two critical issues: staff shortages in specialist services and the difficulty in reaching a significant proportion of those who need assistance. In 2024, there were approximately 6,200 staff working in public services dedicated to illegal substance addiction, 5.7 per cent fewer than in 2019, whilst over the same period the number of clients in care had increased by 1,482.
The professions facing the greatest shortages are educators, with 624 staff members short – equivalent to 49.2 per cent of the required staffing levels – followed by psychologists (420, 30.2 per cent below the standard) and social workers (323). Added to these are 272 doctors and 193 nurses. Regional differences are marked: only Piedmont, Valle d’Aosta, Liguria and Molise collectively meet the staffing levels considered adequate. This gap is reflected in the capacity to provide care: according to Oised estimates, restoring staffing levels to the planned levels would theoretically enable the SerD services to take on around 45,000 more people each year.
But the problem does not only concern those who manage to access specialist services. According to the report, in the case of drug and alcohol addiction, the proportion of eligible people actually reached by the services remains below 10 per cent. A significant proportion only seek help once the situation has already become critical.
This is where the network of Community Centres comes into play; these are designed to bring healthcare services closer to the public and to promote integration between general practice, specialist care and social and healthcare support. Ministerial Decree No. 77 of 2022 provides for the possibility of including addiction services within these centres, but does not make this compulsory. The figures show that their use is limited: out of 1,715 planned facilities, as at 31 December 2025, 781 had at least one active service and just 164 provided dedicated addiction care.
